The big health care debate this past week (and it could extend through September) is the re-authorization of SCHIP (State Children Health Insurance Program). SCHIP is a public program that insures poor children. It was initially authorized in 1997 with a 10 year mandate expiring September 30, 2007. Almost all experts, and most politicians, state that SCHIP has been a success. Few would advocate (at least on record) for the dismantling of SCHIP, however, the debate is complicated because the Senate and House versions of the re-authorization call for an expansion of SCHIP to insure “wealthier” children. Some states are calling for universal coverage of children. This expansion is the point of contention. President Bush does not want families to drop private insurance coverage for SCHIP coverage – a phenomenon called “crowd out.” Bush has threatened to veto any bill with expansions putting the entire SCHIP program on the line (over 6 million children).
SCHIP is complicated in its structure and the policy implications are complex. Too much for the casual reader of this blog. If you want more in depth information try here.. Also, Paul Krugman of the New York Times wrote a good Op-Ed piece on SCHIP. It cuts to the core of the issue without overwhelming one with details. You will need to be a Times Select member to access it here.
My question is this. What is more important – the coverage of over 6 million children (predominately poverty stricken) or the fear that a few less poor children might drop off the private rolls and fall onto the public rolls? This question should be the question that lawmakers ask. I’m afraid though that they are asking an ideological question. Small government versus large government? Public health coverage versus private health coverage?